<html>
<head>
<title>Contact form</title>

</head>
<body>
	<form name='contact-form'>
<div>Your Name : </div>
<input class='contact-form-name' id='ContactForm1_contact-form-name' name='name' size='30' type='text' value=''/>
<div>Your Email: <em>(required)</em></div>
<input class='contact-form-email' id='ContactForm1_contact-form-email' name='email' size='30' type='text' value=''/>
<div>Your Message: <em>(required)</em></div>
<textarea class='contact-form-email-message' id='ContactForm1_contact-form-email-message' name='email-message' rows='5'></textarea>
<p></p>
<input class='contact-form-button contact-form-button-submit' id='ContactForm1_contact-form-submit' type='button' value='Send'/>
<div style='text-align: center; max-width: 450px; width: 100%'>
<p class='contact-form-error-message' id='ContactForm1_contact-form-error-message'></p>
<p class='contact-form-success-message' id='ContactForm1_contact-form-success-message'></p>
</div>
</form>
</body>
</html>